National Imaging Associates, a Magellan Health Services Company
Welcome to RADMD

Neighborhood Health Plan of Rhode Island

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Welcome to the Neighborhood Health Plan of Rhode Island page.  The documents below have been designed to help RadMD users navigate the prior authorization process for each program Evolent is responsible for. Additional process-specific training tools and modules can be found via links on the Resources tab at the top of the screen.

If you have any questions about our programs, please contact your dedicated Evolent Provider Engagement Manager:

Effective January 1, 2026: Evolent will manage Neighborhood Health Plan of Rhode Island D-SNP members (INTEGRITY for DUALS and DUAL CONNECT Plans) for existing Evolent programs.

Advanced Imaging and Cardiology Program

For access to our Advanced Imaging tip sheets/checklists, click here.

For access to our Cardiac tip sheets/checklists, click here.

Interventional Cardiovascular Program - Effective 1/1/26

To view our interventional cardiovascular training video, click here.

For access to our Cardiac tip sheets/checklists, click here.

Musculoskeletal Program - Effective 1/1/26

For scheduled Musculoskeletal surgeries, Neighborhood Health Plan of Rhode Island requires inpatient level of care in the hospital to be authorized through the health plan separately and only initiated after the service has met Evolent's medical necessity criteria and issued an approval. If the member requires inpatient level of care for the procedure, please contact the health plan for associated inpatient level of care authorizations of Evolent approved procedures.

For access to our Musculoskeletal tip sheets/checklists, click here.

Physical Medicine Program

For access to our Physical Medicine tip sheets/checklists, click here.

Physical Medicine Program - Integrity MMP - Effective 3/1/2025

For access to our Physical Medicine tip sheets/checklists, click here.

Peer-to-Peer Process  

For access to our peer-to-peer process, click here.

Conservative Treatment Forms  

For access to our conservative treatment forms, click here.

Clinical Guidelines

  • Clinical Guidelines
  • Refer to the Utilization Review Matrix document to view specific codes managed by Evolent.